SKIN DIFFERENT KINDS OF BODY FOCUSED REPETITIVE BEHAVIOR

DERMATILLOMANIA
Also known as excoriation disorder, or compulsive skin picking, dermatillomania is a psychological condition that
manifests in the form of repetitive touching, scratching, picking, and digging at one’s own skin.It is an impulse-
control disorder and one of several body-focused repetitive behaviors (BFRB) currently classified in the DSM-5
as Obsessive Compulsive and Related Disorders. Dermatillomania affects up to 5 percent of the population and
approximately 75% of those are female. Wearing bandages on your fingers or keeping your hands busy with a
fidget spinner may stop you from picking so much.

DERMATOPHAGIA
This is when you chew on your skin, then eat it or the scabs. Tension and worry can be a trigger. Something
you feel on your skin, like a hangnail, can also set you off. Some people find they can get rid of this BFRB in
baby steps. For instance, choose a small area (like your thumbs) to stop chewing. Work your way up to one
set of nails, then the other, and continue from there.

MOUTH

MORSICATIO BUCCARUM
People with this BFRB can’t stop biting the inside of their mouths. Over time, this causes sores and swelling.
The inner lining of your mouth can also start to feel bumpy, which may make you want to chew it more.
Since people often do this to self-soothe, it can help to find a different action, like chewing gum, that gives
you the same feeling

MORSICATIO LABIORUM

Some people chew on the sides of their tongues. It’s more common than you’d think and is often caused
by stress. Your dentist may suggest that you wear a special mouth guard that covers your teeth and
shields your tongue. You can also talk to your doctor about ways to better manage your stress.

MORSICATIO LINGUARIUM

This is when you have the urge to chew, bite, or suck on your inner lip. After a while, it can make the
skin cells on your lip slough off and create a rough white, gray, or yellow patch. Wearing a “lip bumper,”
a device that keeps your lower teeth away from your lips, can help break this cycle. Talk therapy can
also help you deal with feelings that may be behind this BFRB.

HANDS
ONYCHOPHAGIA

Onychophagia, or onychophagy, is considered a pathological oral habit and grooming disorder characterized by
chronic, seemingly uncontrollable nail biting that is destructive to fingernails and surrounding
tissueOnychophagia is classified in the DSM-5 as an “Other Specified Obsessive-Compulsive and Related
Disorder.”Keeping your nails trimmed short can help. You can also use a special nail product that has a bitter
taste.
 DIFFERENT KINDS OF BODY FOCUSED REPETITIVE BEHAVIOR

ONYCHOTILLOMANIA

If you have this BFRB, you can’t stop picking or pulling at your fingernails and toenails, as well as the skin
around them. (You may also chew or bite them.) Over time, this leads to hangnails and open sores, and
you can pass germs from your mouth into your skin. That can lead to infections. Instead, you might play
with Silly Putty or squeeze a stress ball. Wearing a pair of gloves could help, too.

NOSE
RHINOTILLEXOMANIA

If you pick your nose so much that it affects your daily life, you may have rhinotillexomania. In some
cases, people spend hours each day trying to clean out their noses. People who have this BFRB are
also more likely to have another one, like skin picking or biting their nails.

HAIR
TRICHOTEMNOMANIA

In Greek, “temnein” means “to cut” and “trich” is ”hair.” If you have this BFRB, you have a strong urge to
remove hair from your body. This includes more than what’s on your scalp. You may also cut or shave
your eyebrows, the hair on your arms, legs, or pubic area. Like hair-pulling, trichotemnomania’s an
obsessive-compulsive act. Deep down, you may believe cutting your hair will get rid of unwanted
thoughts.

TRICHODAGANOMANIA

Hair biting is the basis of this BFRB. Since it’s hard to chew on the hair attached to your scalp, most people
nibble hair on other parts of their body. Like all BFRBs, negative feelings can be a root cause. Doing
something else with your mouth can help. For example, you might chew on gum or a raw piece of
spaghetti. You could also suck on a mint or crack open sunflower seeds with your teeth.

TRICHOTILLOMANIA

Some people yank hair from their heads, eyelashes, eyebrows, or other parts of their bodies. Anxiety or
boredom can trigger it. In some cases, people don’t know they’re pulling their hair. Trichotillomania often
starts between ages 10 and 13, but it can be a problem for life. You can try to replace it with another,
more healthy habit. For example, you might knit, crochet, or cross-stitch to keep your fingers busy.

THRICHOPHAGIA

As many as 20% of people who pull their hair also eat it. Some people nibble at the roots, while others eat
bunches. In very rare cases, people eat other people’s hair or hair from animals. If you swallow a lot of hair,
you can get a hairball in your stomach. If that happens and it’s not taken out, it can be life-threatening.
 CONSEQUENCES OF BODY FOCUSED REPETITIVE BEHAVIOR

Physical Emotional Financial

Baldness or alopecia areata Shame Cost of wigs, makeup, prosthetic brows

Scars, wounds infections Isolation and lashes
Repetitive strain Injury Avoidance of Relationships, Education, Time spent pulling/ picking leads to
Callouses on Fingers Career Pursuits missed education, work, time spent with
Trichobezoar (Undigested hair) Negative Reactions from others (teens) family.
Dental Impact Fear of being detected Missed education and career opportunities
Higher incidence of depression,
generalized anxiety disorder, and OCD in
people with Trichotillomania

Treatment Can Help

Cognitive Behavioural Therapy (CBT) may help the most. This type of therapy helps to make you aware of your feelings and thoughts and gives
you more control over them. Sometimes medicines can help, too. Talk with your doctor or therapist about what might work best for you.

Findings
• The causes of BFRBs is unknown
• Trichotillomania (hair pulling) affects between 1-5% of people- it is relatively common
• Excoriation Disorder (skin picking) affects up to 4% of people
• The average age of onset is between 11-15 (around age 12 for hair pulling and 15 for skin picking)
• In children hair pulling is about 50:50 boys to girls, but in adults it is 10:90 and for skin picking it is 20:80 male to female
• Trichotillomania and excoriation disorder are both listed in the Diagnostic and Statistical Manual of Mental Disorders; both are considered
obsessive-compulsive spectrum disorders, though they're unique from OCD. (Nail biting, lip chewing, nose picking and other behaviors
aren't yet listed; they aren't as often reported, nor are they as widely studied.)

References
https://www.psychologytoday.com/us/conditions/onychophagia-nail-biting
https://www.webmd.com/mental-health/ss/slideshow-understanding-body-focused-repetitive-behavior
http://www.bfrb.org/learn-about-bfrbs
https://www.psychologytoday.com/us/basics/body-focused-repetitive-behaviors
https://www.psychologytoday.com/us/conditions/dermatillomania-skin-picking
https://www.webmd.com/vitamins/ai/ingredientmono-1018/n-acetyl-cysteine
https://health.usnews.com/health-news/health-wellness/articles/2015/08/10/understanding-body-focused-repetitive
behaviors?fbclid=IwAR3UZH5CCqliqd_wrMyN9HsdAYpMZ9G97YVGNSZUee8Innr8Al-fNccyTGI